Until now. But it's a good new thing! Sort of.
What's happened is that the metastatic cancer spot on my sternum showed additional takeup on my annual bone scan in August over the August, 2015 scan (the one from the previous year). The way the scan works is they inject me with a radioactive tracer which settles in my bones. Areas where there's more tracer have additional takeup, and this means that some kind of activity is going on there. We redid the scan in November and it showed the same amount of additional takeup over the scan from August, 2015.
Between the scan results and the fact that I've been experiencing additional pain in my sternum over the last eight months or so, it's reasonable to conclude that my spot is starting to be active again. There are no other spots showing up in any other area: the only active area is this spot on my sternum.
So my oncologist suggested that we see if we can get rid of it with a type of focused radiation called stereotactic body radiotherapy (SBRT) (aka stereotactic ablation radiotherapy, or SABR). In this treatment, the tumour/lesion/spot is basically burned out and because the radiation is focused, there isn't as much damage to surrounding tissue. My cancer centre recently got the equipment to do this type of treatment so it could be done locally. She sent me for a consultation with a radiation oncologist, who I saw today.
I am a candidate for the SBRT because my sternum hasn't received the maximum lifetime dose of radiation. Apparently, although SBRT is in use throughout the body - including in the brain, liver, and lungs - and it's been extremely well-studied in all those places, it's less well-studied in bones. This doesn't mean that it won't work, just that the benefits and side effects aren't quite as well-understood. I didn't see this as a reason to not do it.
Benefits of the treatment is that it'll take my spot out, which will reduce the amount of metastatic cancer in my body. Yay! The radiation oncologist also indicated that I should see reduced pain in the sternum after the initial spike. Yay again! Side effects of the treatment include fatigue, initial increased pain, and possible tissue damage. Side effects from that tissue damage depend on which tissue is damaged, but can include heartburn, lung damage, rib damage, etc. One other side effect is that my sternum will become very fragile so it could break more easily.
The radiation oncologist has to check what doses I've received and where and make up a plan for me but she thinks that I'll get one or two treatments. I'll need a CT scan for positioning (applying radiation has to be a very thorough and detailed process to minimize tissue damage.
I'll be posting updates about the this treatment and side effects so watch this space for more details.